Indian journal of anaesthesia
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Opioid-free anaesthesia (OFA) is an anaesthetic technique where non-opioid drugs are used in the intraoperative period. It can be successful without using alpha-2 agonists, which are main drugs used in this multimodal anaesthesia. We are presenting seven different cases where OFA was used in different abdominal surgeries (laparoscopic cholecystectomy, colon cancer operation, and laparoscopic inguinal hernia repair) alone or in a combination with epidural anaesthesia and peripheral nerve block. ⋯ After tracheal intubation anaesthesia was maintained with sevoflurane and continuous infusion with lignocaine, magnesium sulphate, and ketamine (in some patients). At the end of the surgery, all patients received metamizole. The postoperative pain scores were reduced in most of the patients without giving opioids.
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Postoperative nausea and vomiting (PONV), one of the common complications following strabismus surgery, would delay the ambulatory discharge time. The aim of this retrospective study was to determine the risk factors of PONV in patients undergoing ambulatory strabismus surgery under general anaesthesia, with the treatments of dexamethasone and 5-HT3 antagonist combination. ⋯ The sum of the extraocular muscles manipulated and the use of nalbuphine are potentially modifiable risk factors for PONV after strabismus surgery with the treatments of dexamethasone and 5-HT3 antagonist combination.
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Management of the recent outbreak of the novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) remains challenging. The challenges are not only limited to its preventive strategies, but also extend to curative treatment, and are amplified during the management of critically ill patients with COVID-19. Older persons with comorbidities like diabetes mellitus, cardiac diseases, hepatic impairment, renal disorders and respiratory pathologies or immune impairing conditions are more vulnerable and have a higher mortality from COVID-19. ⋯ However, in patients with COVID-19, the guidelines need to be modified,due to various concerns like differing etiology of cardiac arrest, virulence of the virus, risk of its transmission to rescuers, and the need to avoid or minimize aerosolization from the patient due to various interventions. There is limited evidence in these patients, as the SARS-CoV-2 is a novel infection and not much literature is available with high-level evidence related to CPR in patients of COVID-19. These suggested guidelines are a continuum of CCLS guidelines by IRC with an emphasis on the various challenges and concerns being faced during the resuscitative management of COVID-19 patients with cardiopulmonary arrest.